Developing country-specific wheelchair service provision strategic plans for Romania and the Philippines

Provision of paediatric wheelchairs in low resource settings: a scoping review

PURPOSE

Inadequate wheelchair provision in children can lead to delays in growth and development, poorer health, and decreased participation. Wheelchair provision for children can be challenging, especially in low-resource settings, due to limited resources. Therefore, the purpose of the scoping review was to gain an understanding of the current state of paediatric wheelchair provision in low resource settings and identify factors, strategies, and gaps that can lead to more successful wheelchair provision.

METHODS

This scoping review used literature published after 2010, related to paediatric wheelchair provision in low resource settings. We searched online databases and grey literature and extracted data based on categories from the World Health Organisation Guidelines to wheelchair provision in low resource settings.

RESULTS

34 articles were used to identify and analyse common themes and successful strategies related to wheelchair provision for children in low resource settings. Aspects of paediatric wheelchair provision were mentioned in the literature but were rarely the focus. End-user outcomes were the least represented category in the literature.

CONCLUSION

Based on the currently available evidence the overall state of a wheelchair for children is inadequate. Improvements in design and production, personnel capacity, and service delivery systems are recommended to promote best practices. The lack of child-focussed wheelchair provision and end-user involvement in the research process urgently needs to be addressed.Implications for RehabilitationIdentify best practiceIdentify gaps in knowledgeDetermine areas of need for future research.

Developing an International Occupational Therapy Service: Perspectives and Implications

Mali is one of the poorest countries in sub-Saharan Africa. Limited infrastructure renders access to health care difficult. There is a need to establish functional ways to improve Malian people’s health and treat disability. From this point of view, our project aims to implement a remote occupational therapy service for the beneficiaries of the Kalana clinic in Mali through international cooperation. Using a spiral iterative model, a proposal for a remote occupational therapy service was developed and refined for a multidisciplinary context. The International Classification of Functioning, Disability, and Health (ICF) was used as a means to work from a multidisciplinary approach to treat all needs. The results are exemplified with a case report and qualitative impressions of the services.

An exploratory analysis of global trends in wheelchair service provision knowledge across different demographic variables: 2017-2020

OBJECTIVE

To explore global trends in manual wheelchair service provision knowledge across geographic, professional, and socioeconomic domains.

DESIGN

A secondary analysis of a dataset from the International Society of Wheelchair Professionals' Wheelchair Service Provision Basic Knowledge Test was conducted.

SETTING

The dataset included test takers from around the world and was extracted from Test.com and International Society of Wheelchair Professionals' Wheelchair International Network.

PARTICIPANTS

2,467 unique test takers from 86 countries.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

International Society of Wheelchair Professionals' Wheelchair Service Provision Basic Knowledge Test.

RESULTS

We identified significant inverse associations between pass rate and the following variables: education (high school and some college), test taker motivation (required by academic program or employer), and country income setting (low and middle). There were significant positive associations between pass rate and the following variables: training received (offered by Mobility India or 'other NGO'), and age group served (early childhood).

CONCLUSION

Global wheelchair knowledge trends related to key variables such as training, occupation, and income setting have been preliminarily explored. Future work includes further validation of the primary outcome measure and recruitment of a larger sample size to further explore significant associations between additional test taker variables.

Understanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper

Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.

Preliminary steps of the development of a Minimum Uniform Dataset applicable to the international wheelchair sector

Assistive products outcomes are needed globally to inform policy, practice, and drive investment. The International Society of Wheelchair Professionals developed a Minimum Uniform Dataset (MUD) for wheelchair services worldwide with the intent to gather data that is comparable globally. The MUD was developed with the participation of members from around the globe and its feasibility piloted at 3 sites. Three versions of the MUD are now available—a short form with 29 data points (available in English, Spanish, and French) and a standard version with 38 data points in English. Future work is to validate and complete the translation cycles followed by promoting the use of the MUD globally so that the data can be leveraged to inform policy, practice and direct investments.